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  • Friends Life Individual Protection

    Critical Illness Cover and Critical Illness with Life CoverMembership handbook

    FLIP/4564/May14

  • Membership handbook

    Contents Welcome 3

    General definitions 5

    Critical illness definitions 9

    Your membership 19

    Additional options 22

    What you are covered for 30

    What you are not covered for 39

    Changes to your membership 42

    Premium options 48

    How to make a claim 51

    Your right to cancellation 55

    General information 57

    Getting in touch 60

  • Welcome

    | 3

    Welcome

    Thank you for choosing Friends Life Individual Protection

    Thank you for choosing critical illness cover

    or critical illness with life cover from

    FriendsLife Individual Protection.

    FriendsLifeIndividual Protection products

    are provided by Friends Life and Pensions

    Limited, part of the Friends Life group.

    With this membership we aim to provide you

    and your dependants with protection should

    serious illness or incapacity affect the

    members ability to work and cause you

    financial hardship, and help secure your

    dependants financial future if a member is

    to die.

    The membership has been designed to offer

    you the flexibility to provide you with the right

    level of financial health protection to match

    your circumstances.

    Friends Life flexible financial protection is the

    umbrella plan which provides cover through a

    series of separate memberships for different

    types and levels of cover.

    Your registration certificate will show which

    type of membership you have. Each

    membership will have a separate handbook.

    This handbook explains what is covered by

    Friends Life Individual Protection Critical

    Illness and Friends Life Individual Protection

    Critical Illness with Life Cover and what to do

    if you need to make a claim.

    Using the membership handbook

    The terms and conditions of this membership

    handbook are the terms and conditions on

    which we intend to rely. For your own benefit

    and protection, you should read the terms

    and conditions carefully. If you do not

    understand any point please ask us for further

    information.

    Where the words we, us or our are used,

    this refers to Friends Life and Pensions

    Limited. The words you or your refer to the

    person, or people, who are entitled to receive

    the benefits of the membership. Where we

    refer to the member(s), this refers to the

    person, or people, covered under the same

    membership. The terms you and member may

    refer to the same people or different people.

    Words printed in bold type in this handbook

    are defined terms. Defined terms have a

    specific meaning explained in the definition

    section below or later on in the terms of this

    handbook.

  • Welcome

    Where we refer to you or to the member and

    this refers to two people, we mean both

    people jointly unless we say otherwise. For

    example, where we say we will pay the

    benefit to you, we mean both schemeholders

    jointly, we will not pay the benefit twice.

    Fairness of Terms(a) In making decisions and exercising

    discretions given to us under the terms and

    conditions of this membership handbook,

    Friends Life will act reasonably and with

    proper regard to the need to treat you and

    our other customers fairly.

    (b) The terms and conditions in your

    membership handbook will only apply

    provided that they are not held by a relevant

    court or viewed by the Financial Conduct

    Authority or by us to be unfair contract terms.

    If a term is unfair it will, as far as possible, still

    apply but without any part of it which causes

    it to be unfair.

    4 |

  • General definitions

    | 5

  • 6 |

    General definitions

    General definitionsPlease refer to the definition explanations

    below for further information on their

    meanings.

    Average Weekly Earnings

    The measure used by the Office of National

    Statistics which has replaced the average

    earnings index. This measure is an indicator

    of short-term earnings growth and provides

    a monthly estimate of the level of average

    weekly earnings per employee. Alternatively,

    if this measure is not published during any

    period of your membership the average

    weekly earnings measure will be any

    substituted index or index of figures

    published by that Office.

    Benefit

    The critical event benefit shown on your

    registration certificate excluding the

    terminal illness benefit. However, where

    benefit is used in this handbook as being of

    general application to all benefits covered by

    this handbook, it shall be read so as to read

    the benefit or the terminal illness benefit

    as appropriate.

    Friends Life Individual Protection approved hospital

    A centre of treatment which is registered, or

    recognised under the local countrys laws, as

    existing primarily for:

    carrying out major surgical operations; or

    providing treatment which only consultants can provide

    and which has been approved by Friends Life

    Individual Protection.

    Child / children

    Any natural child or adopted child of you or

    your spouse, partner or civil partner or any

    child for which either you or your spouse,

    partner or civil partner are the legal guardian.

    Childcover benefit

    The childcover benefit as defined in the What

    you are covered for section in this handbook.

    Child funeral benefit

    The child funeral benefit as defined in the

    What you are covered for section in this

    handbook.

    Commencement date

    The date your membership starts, as shown

    on your registration certificate.

    Consultant

    A surgeon, anaesthetist or physician who:

    is legally qualified to practice medicine or surgery following attendance at a

    recognised medical school; and

    is recognised by the relevant authorities in the country in which the treatment takes

    place as having specialised qualification in

    the field of, or expertise in, the treatment

    of the disease or illness being treated.

    By recognised medical school we mean a

    medical school which is listed in the World

    Directory of Medical Schools, as published

    from time to time by the World Health

    Organisation.

  • | 7

    General definitions

    Critical illness(es)

    Any of the illnesses and operations as defined

    in the Critical illness definitions section in this

    handbook relate to any illness or operation

    separately, not all of them together.

    Endorsement(s)

    Change(s) that you require and we agree to

    be made to your membership after it

    commences which are recorded in the

    endorsement section of your registration

    certificate.

    Fracture

    The fractures defined in Blacks Medical

    Dictionary (39th edition), comminuted,

    complicated, compound, depressed,

    greenstick, pathological and simple. The

    fracture definition does not include any other

    type of fracture.

    Full time employment

    Working a minimum of 35 hours a week.

    Handbook

    This handbook setting out the general terms

    and conditions of your membership.

    Irreversible

    Cannot be reasonably improved upon by

    medical treatment and/or surgical

    procedures used by the NHS in the UK at the

    time of the claim.

    Member

    The person (or people) named as a member in

    your registration certificate. This is the

    person (or people) for whom cover is provided.

    Membership

    The agreement between you and us to

    provide the benefit on the terms set out in

    the handbook and the documents referred

    to in the section Your membership.

    Mental impairment

    Mental disorder causing incapacity which has

    failed to respond to a minimum of two years

    optimal treatment by a consultant

    psychiatrist and requires the need for

    continuous psychotropic medication,

    supervision and care from a consultant and

    results in severe dysfunctioning and the

    prognosis is considered poor or worse.

    NHS

    National Health Service.

    Occupation

    A trade, profession or type of work

    undertaken for profit or pay. It is not a

    specific job with any particular employer and

    is independent of location and availability.

    Permanent

    Expected to last throughout the life of the

    person covered, irrespective of when the

    membership ends or the member expects

    to retire.

    Permanent neurological deficit with persisting clinical symptoms

    Symptoms of dysfunction in the nervous

    system that are present on clinical

    examination and expected to last throughout

    the members life.

  • Symptoms that are covered include

    numbness, hyperaesthesia (increased

    sensitivity), paralysis, localised weakness,

    dysarthria (difficulty with speech), aphasia

    (inability to speak), dysphagia (difficulty in

    swallowing), visual impairment, difficulty in

    walking, lack of coordination, tremor, seizures,

    lethargy, dementia, delirium and coma.

    The following are not covered:

    an abnormality seen on brain or other scans without definite relat